| NPI | 1023054426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NH 039337-23-11) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 039337-23-11) |
| 363L00000X Nurse Practitioner (Licence: NH 039337-21) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2010-09-23 |